2022 World Conference on Lung Cancer (ePosters)-EP04.01-001. Prevalence And Outcomes of EGFR Exon 20 Insertion Mutation In NSCLC: Princess Margaret Cancer Center Experience

EP04.01-001. Prevalence And Outcomes of EGFR Exon 20 Insertion Mutation In NSCLC: Princess Margaret Cancer Center Experience

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This study conducted at the Princess Margaret Cancer Center in Canada aimed to examine the prevalence and outcomes of patients with EGFR exon 20 insertion mutation in non-small cell lung cancer (NSCLC). The researchers conducted a retrospective chart review of patients diagnosed with stage-IV EGFR-mutated NSCLC between 2014 and 2018. They also included additional patients based on clinician review up to 2019 for survival analysis.<br /><br />Among the 236 patients with EGFR-mutated stage IV NSCLC, 11 (4.7%) had EGFR exon 20 insertion, with an estimated prevalence of 1.5% among all metastatic NSCLC patients. The median age of patients with exon 20 insertion was 65.8 years, and 62% were female. Compared to patients with classical EGFR mutations, those with exon 20 insertion were more often Caucasian but had similar rates of smoking.<br /><br />In terms of treatment, patients with exon 20 insertion received various therapies, including chemotherapy, combination chemoimmunotherapy, and targeted therapies such as afatinib and gefitinib. However, the outcomes for patients with exon 20 insertion were inferior to those with classical EGFR mutations treated with the standard-of-care drug osimertinib. The median progression-free survival for patients with exon 20 insertion was 10.5 months, compared to 11.8 months for patients with classical EGFR mutations treated with gefitinib and 17.4 months for those treated with first-line osimertinib.<br /><br />Additionally, the median overall survival for patients with exon 20 insertion was 30.8 months, compared to 44.5 months for patients with classical EGFR mutations who received first-line osimertinib. These findings highlight the need for new effective drugs that can improve outcomes for patients with this rare molecular alteration. The study also indicates the potential of new tyrosine kinase inhibitors, such as amivantamab and mobocertinib, which have shown promise in improving outcomes for patients with EGFR exon 20 insertion but are not yet approved by Health Canada.

Asset Subtitle

Abhenil Mittal

Meta Tag

Speaker Abhenil Mittal

Topic Global Health, Health Services Research, and Health Economics - Cost Issues

Keywords

EGFR exon 20 insertion

non-small cell lung cancer

NSCLC

prevalence

outcomes

retrospective chart review

chemotherapy

gefitinib

osimertinib

tyrosine kinase inhibitors